Influenza – State of Healthhttps://ww2.kqed.org/stateofhealth
KQED Public Media for Northern CAThu, 08 Dec 2016 19:25:40 +0000en-UShourly1https://wordpress.org/?v=4.2.2People Say They Go To Work Sick — Even When They Shouldn’thttps://ww2.kqed.org/stateofhealth/2016/07/11/people-say-they-go-to-work-sick-even-when-they-shouldnt/
Mon, 11 Jul 2016 21:12:30 +0000http://ww2.kqed.org/stateofhealth/?p=211512A majority of working adults say they still go to work when they have a cold or the flu. There are some jobs where doing that can have a big effect on health.

At least half of people who work in very public places, like hospitals and restaurants, report going to work when they have a cold or the flu. Those were among the findings of a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

They are some of the last people you’d want to go to work sick, because they tend to have a lot of contact with people. And that helps spread disease.

“It’s one of the biggest food safety problems that there is, and we’ve known about it forever,” says Kirk Smith, who oversees foodborne outbreak investigations with the Minnesota Department of Health. But he says it’s really hard to get people to stop doing it.

When it comes to food handling, there’s one illness that’s particularly concerning: norovirus. “It is by far the most common cause of foodborne illness,” says Smith. According to the Centers for Disease Control and Prevention, the virus is responsible for 35 percent of them.

That’s because there are billions of virus particles per gram in stool and vomit. It takes only about 20 of those to get someone sick. And norovirus can hitchhike from surface to surface. It takes a high concentration of bleach to kill it.

“And so it just takes microcontamination of your hands, if you don’t do a perfect job washing, to be able to contaminate food with enough of the virus to infect lots and lots of people,” says Smith.

The same virus has plagued restaurant customers across the country. Last winter, 140 people — including much of the Boston College basketball team — got sick from eating at a Chipotle in Boston where one person had gone to work sick.

“It’s definitely the norm to go into work sick. That’s what I and most of my co-workers usually do,” says Anthony Peeples. He used to work at an Olive Garden restaurant. Now he’s a bartender at a casino in Michigan City, Indiana.

Workers clean a closed Chipotle restaurant in Boston in December after customers became infected with norovirus. (Suzanne Kreiter/Boston Globe via Getty Images)

At Olive Garden, he says, he was in a bind when he got sick, because he didn’t have any paid sick leave.

“I don’t think anybody really wants to go out there and get people sick or let alone work when they’re miserable, but you have to,” he says, “Or else you’re not going to be able to pay your electricity or water or your rent.”

The Food and Drug Administration has something called the Food Code that says food workers need to stay home 24 hours after their symptoms go away, but not all states have adopted the rule.

The CDC has found that one in five food service workers has reported working while sick with vomiting and diarrhea.

People don’t want to leave their colleagues in the lurch, says Laura Brown, a behavioral scientist with the CDC’s National Center for Environmental Health.

She and her colleagues interviewed employees at about 500 restaurants in nine different states and then calculated which factors were most strongly linked to people going to work sick.

“Forty percent of workers did say to us that they’d worked while sick in the past because they wouldn’t get paid,” Brown says. “But when we look at the data statistically, that doesn’t really seem to be a large driving factor in whether or not people actually work when they’re sick.”

A lot of them went to work because they were worried about losing their jobs if they didn’t show. And there was another thing. “We found that workers who were concerned about leaving their co-workers short-staffed were more likely to say they’d worked while sick,” Brown says.

Likewise, those who worked in places that had backup options — like on-call workers to fill in for sick staff — were less likely to work while sick. So the biggest factor, Brown says, was that “the workers are concerned about their co-workers having to work a man down.”

NPR’s poll also found that it isn’t always money that drives people to work when they should stay home.

Adults in low-paying jobs are more likely to say they go to work ill — but about half of those in high-paying jobs are, too.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

]]>Workers clean a closed Chipotle restaurant in Boston in December after customers became infected with norovirus.Workers clean a closed Chipotle restaurant in Boston in December after customers became infected with norovirus.Screen Shot 2016-07-11 at 2.06.45 PMWhy You Can’t Get the Flu from the Flu Shot (Video)https://ww2.kqed.org/stateofhealth/2015/11/16/why-you-cant-get-the-flu-from-the-flu-shot-video/
https://ww2.kqed.org/stateofhealth/2015/11/16/why-you-cant-get-the-flu-from-the-flu-shot-video/#commentsMon, 16 Nov 2015 18:48:31 +0000http://ww2.kqed.org/stateofhealth/?p=109229It’s the time of year when the flu starts circulating more widely and with it — the myths about the flu shot start circulating, too.

In just over 2 minutes, The Slate does a highly entertaining job of debunking one of the most tenacious myths of all — that you can get the flu from the flu shot. You can’t.

The Centers for Disease Control recommends that everyone over 6 months get the flu shot. While effectiveness varies from year to year, this year’s version is expected to be a good match against the specific strains of influenza that are circulating this season.

Update February 21, 2014: The California Department of Public Health says 278 people have died of flu so far this year, and an additional 29 deaths are under investigation. While cases have been declining for a few weeks, state health officials still recommend people get vaccinated, if they haven’t already.

State health officials have released the latest numbers on flu deaths — 202 people have died so far this year and that’s up from 147 last week. That’s the bad news, but for the first time since early January, health officials are also saying that cases appear to be declining. At least for now. Flu season generally runs three months and is “notoriously unpredictable,” said Dr. James Watt, with the California Department of Public Heatlh and recommended that everyone got vaccinated.

Here at State of Health, we’ve noticed that a lot of the same questions come up again and again. With that in mind, we’ve compiled some answers.

1. Is the flu shot really the best way I can avoid getting the flu? In a word, yes. The Centers for Disease Control (CDC) says “the single best way to protect against the flu is to get vaccinated each year.” And you need to get it annually. While everyone over age 6 months should have it, CDC says, it’s especially important for people in high risk groups including:

Getting the flu shot is not a guarantee that you will not get the flu. No vaccine is perfect, but even if you get sick, you are likely to have a more mild course of illness if you have had the vaccine. If you haven’t gotten vaccinated yet, you can find a flu shot location near you by entering your zip code on this map run by the federal government.

(As an aside, I became a fan of the flu shot after I got the flu many years ago. It came on suddenly one afternoon — but I had Bruce Springsteen tickets that night and was determined to go. I felt worse and worse all afternoon. When I got to the Coliseum, I believe I heard the first couple songs and then fell asleep. I proceeded to sleep and fight fever for the next two days, then spent another several days recovering. It was awful.)

2. Why is the H1N1 strain such a big deal? The H1N1 strain surfaced in April, 2009. The first reported cases were in Mexico, and the strain went on to cause a “pandemic” (i.e., a global epidemic). Scientists raced to create a vaccine, but it took months. In California alone, over a roughly 16 month period, more than 600 people died. What was unusual about this strain is that the death rate in adults under 65 was higher than adults over 65. Usually influenza hits the elderly harder. Epidemiologists theorize that a similar strain may have been circulating decades ago, so older adults have some immunity to H1N1. But those under 65, not so much.

3. Why does California only track flu deaths in people under 65? Taking a step back, state officials say they believe California is the only state that tracks all flu deaths in adults. The CDC samples the country and then estimates deaths for people of all ages, but does not require reporting of all flu deaths from any state. California only started tracking flu deaths on a case-by-case basis in the 2011-2012 flu season. The legislature had passed a mandatory reporting requirement in the wake of the H1N1 pandemic noted above. The state says the goal of reporting is to track the severity of the flu season. Because flu is so common in the elderly, the state says, tracking deaths in that group would not be as good an indicator of severity. And besides, it’s not required by law.

4. Can the flu shot give me the flu? In a word, no. The vaccine is created from killed viruses. While the shot cannot give you the flu, it can have minor side effects including soreness or swelling at the site of the injection, low fever or aches. Many children like the nasal spray vaccine. Here the viruses are weakened and cannot cause severe flu symptoms. But it still can cause minor side effects including runny nose, wheezing, aches and fever. CDC says that if these side effects happen, they usually start soon after vaccination and don’t last long.

5. If the flu season is peaking, then I don’t need to worry about the flu until next year, right? Um, no. This question comes up frequently in the weekly media call about flu with state health officials. They’re pretty clear that flu is unpredictable, that you can only know the season has ended after it has ended, and that even if we’re past a peak now, there could be another round — something they referred to as the “double bump.” Health officials continue to encourage everyone over age 6 months to get vaccinated. While it can take two weeks for antibodies to kick in after you get the vaccine, you will be protected after that.

Learn more:

KQED Newsroom’s Thuy Vu discussed this year’s flu season with Dr. Erica Pan, Alameda County of Public Health, and me Friday night on the program.

State health officials reported Friday that deaths from influenza have reached 147, including four children under age 18. Another 44 deaths are under investigation, but not confirmed.

The total deaths so far this flu season, which started last September, eclipses the number from all of last year — 106.

As health officials have noted all month, the H1N1 strain is circulating — that’s the same strain that led to the pandemic in 2009-2010. Younger adults are at increased risk from H1N1. The theory is that adults over 65 were exposed to H1N1 decades ago and have retained some immunity. Younger adults were (presumably) never exposed so have no natural protection.

Health officials urged all Californians over age 6 months to get a flu shot. This year’s vaccine is well-matched to the circulating strains, health officials say. They urge people who believe they have the flu to contact their doctors immediately and ask about anti-viral medications.

State health officials reported Friday that fatalities from influenza now stand at 95 statewide — with another 51 deaths reported from local jurisdictions under investigation.

That brings the total to 146 deaths — more than the 106 deaths California had during all of last year’s flu season.

“We so far have a much more severe season,” said state epidemiologist Dr. Gil Chavez with the California Department of Public Health. A child in Riverside County was among last week’s fatalities, bringing to three the number of fatalities in children statewide. All of them were under age 10.

Chavez noted that the H1N1 strain is the culprit and says the strain causes more severe disease and more deaths. In addition, it tends to hit younger people harder, in particular those with pre-existing health conditions.

While doctor’s office visits and hospitalizations for flu were fewer last week than the week prior, Chavez said it was impossible to know if the flu season is peaking. “It’s too early to tell whether or not it’s a trend,” Chavez told reporters in a media call Friday morning. “We know that the flu is rather unpredictable, and it has ebbs and flows.”

Chavez urged those who are not vaccinated to get a flu shot, saying that there’s good availability of the vaccine statewide and that it is the best way people can protect themselves from the illness. He stressed that people with chronic health conditions are at higher risk and should be vaccinated.

Pregnant women should also get the flu shot, he said. Influenza can cause more serious illness in pregnant women than in women who are not pregnant. Women can “have a healthier pregnancy and avoid complications” of the flu, he said. Plus the shot may provide some immunity to the fetus as well.

If you’ve been following this year’s flu season, you may have noted that flu deaths are only reported for people under 65. California is the only state that mandates reporting of flu deaths, said Dr. James Watt, chief of the division of communicable disease control. The surveillance was put in place in the wake of the 2009 H1N1 pandemic. Flu deaths are more common among people over age 65 and may not be an indication of the severity of the season, health officials say.

State health officials are urging Californians to get vaccinated against the flu. At least nine people have died in the Bay Area in recent weeks.

The main culprit is the H1N1 strain, also known as swine flu. This is the same subtype of influenza that caused a pandemic in 2009-2010.

The vaccine is widely available and well suited to protect against the circulating H1N1 strain, officials say. Doctors’ offices, pharmacies and grocery stores carry the vaccine. In addition, local health departments generally provide the vaccine at low or no cost.

Usually influenza is most dangerous to people over 65, but the H1N1 strain is hitting younger adults harder this year, said Dr. Janice Louie, public health medical officer for the California Department of Public Health. In particular this year, adults ages 30-50 who also have chronic illnesses are at greatest risk of complications from the flu, she said. Those illnesses include lung diseases, such as emphysema and asthma, diabetes, heart disease, cancer or HIV. People who are obese are also at greater risk of severe influenza.

“For those people who have risk factors who get ill, they should see their doctor right away,” Louie said, “because there are antiviral treatments that can help prevent the infection from becoming more severe and prevent progression into pneumonia.”

Sacramento County has been hard hit by flu. Already this year, four people have died. In Contra Costa County, 18 people are hospitalized in the ICU with complications from influenza. Hospitals in Sacramento County are seeing a surge in admissions, including children, the Sacramento Bee reports.

Fever or feeling feverish/chills (CDC says not everyone with flu will have fever.)

Cough

Sore throat

Runny or stuffy nose

Muscle or body aches

Headaches

Fatigue (tiredness)

Some people may have vomiting and diarrhea, though this is more common in children than adults

]]>https://ww2.kqed.org/stateofhealth/2014/01/08/flu-now-widespread-in-california/feed/18165753357_390e69f46c_b-2Nursing student administers flu shot. (queensu/Flickr)New Flu Strain in China: How Far Will It Spread?https://ww2.kqed.org/stateofhealth/2013/04/04/new-flu-strain-in-china-how-far-will-it-spread/
https://ww2.kqed.org/stateofhealth/2013/04/04/new-flu-strain-in-china-how-far-will-it-spread/#respondThu, 04 Apr 2013 18:06:22 +0000http://blogs.kqed.org/stateofhealth/?p=11967It was four years ago this month that a new strain of flu virus was reported in Mexico and captured global attention. Ultimately, the World Health Organization declared it a pandemic. More than 18,000 people died in 2009 from the virus.

Now, in China, global influenza experts are watching another novel virus, H7N9. So far, nine people are sick, and three are dead. As Helen Branswell at The Canadian Press (and self-described “flu freak“) reports “those first three sick people and the genetic sequences of the flu viruses that infected them were enough to make the hairs on the backs of knowledgeable necks stand on end.”

Branswell also tweeted that case “numbers are a moving target” right now.

She lays out why flu experts are racing to determine if we’re on the brink of the second pandemic in five years in this report:

Influenza scientists always pay attention when animal flu viruses start making people sick. There is a rich soup of flu viruses in nature, most of which human immune systems have never seen. Many of those viruses, at least in theory, have the potential to trigger pandemics.

So when China notified the World Health Organization over the weekend that it had found three cases of infection with H7N9 viruses, there was immediate concern.

While some H7 viruses have infected people in the past — including two poultry workers in a big H7N3 outbreak in British Columbia in 2004 — viruses bearing an H7 hemagglutinin and an N9 neuraminidase in combination had never been previously known to infect humans.

Adding to the alarm: The three people were not linked. That means each caught the virus from an animal, or a person. The first bet would be animals, but so far the virus hasn’t been found in Chinese poultry or pigs, the likely suspects.

And the cases didn’t live close to one another. Two were in Shanghai, China’s largest megacity. But the third was in the nearby province of Anhui. As more cases have emerged, the geographic distance among infections has become greater, making it increasingly clear that there is H7N9 virus spreading, undetected, over hundreds of kilometres in China.

Dr. Keiji Fukuda, the World Health Organization’s top flu expert explains: “It’s possible that we have infected animals. But we still haven’t detected actually what is the infected animal and whether it’s these animals that are spread out and individuals in a widespread area are coming into contact (with them) and becoming ill.”

The other option? “At the same time you have to be thinking about is there any evidence of person-to-person transmission,” Fukuda, the WHO’s assistant director-general for health security and environment, told The Canadian Press in an interview.

——

When people show up in hospitals sick with pneumonia, it can take a while to figure out what bacteria or virus is making them ill. It takes even longer when tests for known culprits come back negative, and laboratories have to start thinking about whether they are dealing with something new.

The first known H7N9 cases started getting sick in late February. And two died in the first part of March. But once the Chinese hospitals got the country’s public health agency — the China CDC — involved and they found the new virus, that organization quickly mapped the genetic sequences of the first three viruses and uploaded them into a database that international flu scientists can access.

That prompt sharing allowed outside experts to start studying the viruses to look for clues to their origin.

All eight genes of each virus were avian, meaning these were bird flu viruses. But all the viruses showed several genetic changes that scientists who study influenza recognize as signals of a virus adapting to spread in mammals, not birds. Those changes mean the virus is learning to attach to the type of cells people have in their upper airways, the type of cells that human flu viruses infect.

Those signs of adaptation ratcheted up the concern.

“We would be paying very close attention to any situation in which you have a novel influenza virus which has caused some cases of infection and caused some deaths,” Fukuda says.

“But I think that the molecular changes also make us pay a lot of attention.”

Richard Webby, a swine flu expert who runs the WHO’s influenza collaborating centre at St. Jude Children’s Research Hospital in Memphis, Tenn., says those genetic changes suggest the virus may no longer be circulating in birds.

He believes it is in mammals. That could mean pigs, which are called mixing bowls of influenza, because they can be infected with both human and bird flu viruses, providing a chance for genes to swap.

Or it could mean the virus is spreading in people.

Typically with influenza, we see a (relatively) small number of deaths, many very sick people and then a large group with such mild symptoms they might not even know they have the flu.

Right now, experts don’t know if that’s the case with this flu or if it’s something much more serious.

Longtime pandemic-watcher and Pulitzer Prize winner Laurie Garrett filed this piece earlier this week for Foreign Policy where she examines whether the recent (and mysterious) mass deaths of pigs and ducks are linked to the flu deaths in people. “Is this a pandemic being born?” the headline asks.